Provider Demographics
NPI:1760069033
Name:DR. SHUANG GUO, PC
Entity Type:Organization
Organization Name:DR. SHUANG GUO, PC
Other - Org Name:SMILE WITH GRACE DENTAL CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHUANG
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:347-536-4310
Mailing Address - Street 1:195 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1710
Mailing Address - Country:US
Mailing Address - Phone:201-641-1111
Mailing Address - Fax:201-425-7097
Practice Address - Street 1:195 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1710
Practice Address - Country:US
Practice Address - Phone:201-641-1111
Practice Address - Fax:201-425-7097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-24
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty